| To apply for a refund on a
software product you obtained from us, please complete this Declaration
of Removal and License Destruction within 30 days of the date or your
purchase. Be sure to include the reason you are requesting a refund and
sign where indicated. In consideration of my receipt of a refund, I
_________________________________ (print your name) certify that:
(i) I have completely removed from all computers all copies of the
software products and licenses listed below;
(ii) I have destroyed all paper and electronic records of the software
license & serial numbers for the software listed;
(iii) I have not decompiled, reverse engineered or reduced any portion
of the software product to human perceivable form;
(iv) I acknowledge that any continued use of the software, license
and/or serial numbers constitutes willful copyright infringement and
fraud for which I may be liable for criminal prosecution as well as
civil damages of up to $100,000.
My reason for returning the software product and requesting a refund
is:
___ The software failed to work properly and WinSwim Software was unable
to resolve my problem (100% refund)
___ I've decided to abandon using the software (A 10% fee to cover
merchant transaction costs will be deducted from your refund).
Please Explain:
______________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Name of Software Product
_______________________________________________________________________
Company Licensed To
___________________________________________________________________________
Your Name (Please Print)
________________________________________________________________________
Email Address
_________________________________________________________________________________
Date of Purchase _________________________ Date of Refund Request
_________________________
Invoice/Order Number
_________________________________________________
Total Purchase Price
_________________________________________________________
Credit Card Type
____________________________________________________________
Credit Card Number
_________________________________________________________
Exp. Date
_________________________________________________________________
Credit Card Security Code (Required)
___________________________________________
I certify under penalty of perjury that I am an authorized agent for
the above company. I have personally read and reviewed this declaration
and it is true and correct to the best of my knowledge.
Signed:__________________________________________________ Date:
_________________________________
Print and mail to:
WinSwim Software
Attn: Sales Department
P.O. Box 3284
Kirkland, WA 98083-3284 |
